Active NPI
Layla Kidane
- Adult Health Nurse Practitioner
- Newark, DE
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- LP-0010530
- Practice address
- 4755 Ogletown Stanton Road
Suite 5A43
Newark, DE 19718-2200 - Phone
- (302) 623-0188
- Fax
- (302) 733-5640
- NPI assigned
- Apr 23, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | LP-0010530 | DE | |
| Adult Health Nurse Practitioner | 363LA2200X | RN212851 | GA | |
| Gerontology Nurse Practitioner | 363LG0600X | LP-0010530 | DE | |
| Adult Health Nurse Practitioner | 363LA2200X | LP-0010530 | DE | Primary |
| Registered Nurse | 163W00000X | RN212851 | GA |
Addresses
Primary practice location
4755 Ogletown Stanton Road
Suite 5A43
Newark, DE 19718-2200
Mailing address
3232 Oak Vista Way
Lawrenceville, GA 30044-6724
Other practice location 1
3950 Austell Rd
Austell, GA 30106-1121
Phone (770) 732-4022
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DE
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4755 Ogletown Stanton Rd
Newark, DE 19718-2200
Phone (302) 623-0188
Hospital & facility affiliations
- Christiana Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN212851 | GA | MD | Registered Nurse |
| LP-0010530 | DE | MD | Gerontology Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Christiana Care Health Services Inc | Current | Accepting new patients | |
| Christiana Care Health Services Inc | Current | Accepting new patients |
Locations
4755 Ogletown Stanton Rd
Ste 5A43
Newark, DE 19718
Phone (302) 623-0188
1401 Foulk Rd
Ste 100B
Wilmington, DE 19803
Phone (302) 320-9440
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Hospitalist Physician
- Newark, DE
- NPI 1245474329
-
- Neurology Physician
- Chadds Ford, PA
- NPI 1881228484
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Wilmington, DE
- NPI 1134194038
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1366675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1727654400000",
"number": "1124462007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3232 OAK VISTA WAY",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300446724"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4755 OGLETOWN STANTON ROAD",
"address_2": "SUITE 5A43",
"city": "NEWARK",
"state": "DE",
"postal_code": "197182200",
"telephone_number": "302-623-0188",
"fax_number": "302-733-5640"
}
],
"practiceLocations": [
{
"address_1": "3950 Austell Rd",
"address_purpose": "LOCATION",
"city": "Austell",
"state": "GA",
"postal_code": "301061121",
"country_code": "US",
"telephone_number": "770-732-4022",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KIDANE",
"first_name": "LAYLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-04-23",
"last_updated": "2024-09-30",
"certification_date": "2024-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "DE",
"license": "LP-0010530",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "GA",
"license": "RN212851",
"primary": false
},
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "DE",
"license": "LP-0010530",
"primary": false
},
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "DE",
"license": "LP-0010530",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "GA",
"license": "RN212851",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Newark, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.